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Haizel-Cobbina J, Balogun JA, Park KB, Haglund MM, Dempsey RJ, Dewan MC. An Overview of Global Neurosurgery. Neurosurg Clin N Am 2024; 35:389-400. [PMID: 39244311 DOI: 10.1016/j.nec.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
Until recently, surgery had been passed over in the domain of global health, historically being described as "the neglected stepchild of global health." Knowledge of the existing global disparities in neurosurgical care has led to neurosurgery capacity-building efforts especially in low-income and middle-income countries. While many global collaborative projects are currently undertaken with philanthropic support, sustainability and scalability are not likely without governmental adoption of neurosurgery-inclusive national surgical plans. Momentum grows for the global neurosurgery community to develop a global neurosurgery action plan outlining goals, a guiding framework, an execution plan, and indicators for monitoring and evaluation.
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Affiliation(s)
- Joseline Haizel-Cobbina
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA
| | - James A Balogun
- Division of Neurosurgery, Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard University, Boston, MA, USA
| | - Michael M Haglund
- Department of Neurosurgery, Division of Global Neurosurgery and Neurology, Duke University School of Medicine, Durham, NC, USA
| | - Robert J Dempsey
- Department of Neurological Surgery, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Michael C Dewan
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA; Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, TN, USA.
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2
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Dadson SS, Nuamah JA, Kanmounye US, Umutoni A. Building the Next Generation of African Plastic Surgeons. Ann Plast Surg 2024:00000637-990000000-00548. [PMID: 39228023 DOI: 10.1097/sap.0000000000004096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Affiliation(s)
- Shirley Sarah Dadson
- From the University of Ghana Medical School, College of Health, University of Ghana, Accra, Ghana
| | - Jonathan Ayeyi Nuamah
- From the University of Ghana Medical School, College of Health, University of Ghana, Accra, Ghana
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3
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Kuol PP, Lukwesa F, Aganze JM, Muchai E, Mittal G, Emhemed MS, Phiri EC, Adrien TDE. The future of neurosurgery in South Sudan: challenges and opportunities for early researchers. Neurosurg Rev 2024; 47:439. [PMID: 39152357 DOI: 10.1007/s10143-024-02673-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 07/22/2024] [Accepted: 08/09/2024] [Indexed: 08/19/2024]
Affiliation(s)
- Piel Panther Kuol
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- Department of Medicine and Surgery, University School of Medicine, Eldoret, Kenya
| | - Fanwell Lukwesa
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- School of Medicine, The Copperbelt University, Kitwe, Zambia
| | - Josué Mwambali Aganze
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- Faculty of Medicine, Université Catholique de Bukavu, Bukavu, DRC, Congo
| | - Emmanuel Muchai
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- College of Health Sciences, Kenyatta University, Nairobi, Kenya
| | - Gaurav Mittal
- Department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India.
| | - Marwa SaedAli Emhemed
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Emmanuel Chileshe Phiri
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon
- School of Medicine, The Copperbelt University, Ndola, Zambia
| | - Tangmi Djabo Eric Adrien
- Research Department, Association of Future African Neurosurgeons, Yaoundé, Cameroon.
- Faculty of Medicine, Université Technologique Bel Campus, Kinshasa, DRC, Congo.
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Carter A, Findlay MC, Earl ER, Khan M, Bauer S, Farsi K, Lucke-Wold B, Karsy M. Systematic Review of Research, Mentorship, and Career Resources for Medical Students Pursuing Neurosurgical Training. World Neurosurg 2023; 179:28-36. [PMID: 37544605 DOI: 10.1016/j.wneu.2023.07.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Medical students are important team members and future healthcare providers in neurosurgery or other medical fields. We performed a systematic review evaluating studies assessing medical student guidance, mentorship, and career development in neurosurgery. The study aimed to identify the best practices and acknowledge gaps requiring improvement. METHODS A systematic review of 586 research studies evaluating important aspects of medical student career development in neurosurgery was performed. The studies were analyzed for evidence supporting specific strategies to foster career development. RESULTS A total of 45 studies were identified and categorized into 8 categories: 1) medical student interest groups; 2) student fellowships and institutional programs; 3) research and observership funding; 4) medical student research and scholarship; 5) student-led interest groups; 6) student mentorship; 7) educational resources; and 8) diversity, equity, and inclusion for medical students. Studies supported the significant positive effects of career resources for medical students, which often resulted in higher publication quantities, increased interest in the field, and greater ease of matriculation into a neurosurgical residency. One central gap included limited formal opportunities at many institutions, including medical schools without neurosurgery programs. Additional gaps were an absent structure for many forms of mentorship and delayed engagement of medical students in neurosurgical training, which significantly affects career interests. The currently available resources for these aspects of career development are listed. CONCLUSIONS These studies highlight the current endeavors to encourage medical student careers. However, ample gaps and missed opportunities were also identified. Further work at both institutional and national levels is needed to improve the current environment.
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Affiliation(s)
- Ashley Carter
- Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Matthew C Findlay
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA; School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Emma Rose Earl
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah, USA; School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Majid Khan
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Sawyer Bauer
- Reno School of Medicine, University of Nevada, Reno, Nevada, USA
| | - Koorosh Farsi
- Global Neurosciences Institute, Philadelphia, Pennsylvania, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Michael Karsy
- Global Neurosciences Institute, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
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5
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Takoutsing BD, Wunde UN, Zolo Y, Endalle G, Djaowé DAM, Tatsadjieu LSN, Zourmba IM, Dadda A, Nchufor RN, Nkouonlack CD, Bikono ERA, Magadji JPO, Fankem C, Jibia ABT, Esene I. Assessing the impact of neurosurgery and neuroanatomy simulation using 3D non-cadaveric models amongst selected African medical students. FRONTIERS IN MEDICAL TECHNOLOGY 2023; 5:1190096. [PMID: 37215067 PMCID: PMC10192731 DOI: 10.3389/fmedt.2023.1190096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 04/10/2023] [Indexed: 05/24/2023] Open
Abstract
Background Laboratory dissections are essential to acquire practical skills to perform neurosurgical procedures. Despite being traditionally done on cadavers, they are often unavailable and suffer from cultural barriers in the African context. Non-cadaveric UpSurgeOn neurosurgery models have been developed to bridge this barrier, providing an almost similar experience with the human body. This study aimed to assess the impact of the UpSurgeOn hands-on-touch non-cadaver model training amongst selected Cameroon medical students. Methods An anonymous 35-item questionnaire was distributed online using Google drive systems to medical students who attended UpSurgeOn's hands-on-touch non-cadaver model training course. These questions aimed to capture data on previous experience with neuroanatomy and neurosurgery practicals and the perception, attitudes, and impact of the UpSurgeOn neurosurgery tool. Results Eighty-six students completed the survey. The mean age was 21.2 ± 1.868 years, 61.6% were males with 62.8% of respondents being medical students in preclinical years. Before the training, 29.4% had a fair knowledge of neuroanatomy. Textbooks and Youtube videos were the main sources of neuroanatomy and neurosurgery knowledge for more than half of the respondents. Up to 91.5% had no prior exposure to a neuroanatomy/neurosurgery cadaver laboratory dissection, and 22.6% and 17.6% had witnessed and performed at least one craniotomy before, respectively. There were 11.1%, 15.5%, and 31.3% of our respondents who had used a surgical microscope, a neurosurgical instrument, and the UpSurgeOn Neurosurgery tool before, respectively. The majority perceived the UpSurgeOn tool easy to use and felt they needed to learn just a few things before getting going with the box. Most thought of increasing the use of the UpSurgeOn Box and saw the need to be part of the training curriculum. Finally, the majority felt this tool helped to increase familiarity and acquire neurosurgical skills, and to develop the orientation skills needed during neurosurgical approaches. Conclusion Undergraduate exposure to traditional neurosurgery/neuroanatomy labs is limited in Cameroon. Neurosurgery/neuroanatomy practical skills are gained essentially using non-practical means. Most students found the UpSurgeOn tool user-friendly, saw the need to incorporate it as part of their training, and perceived it to be essential in getting acquainted with neurosurgical skills.
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Affiliation(s)
- Berjo Dongmo Takoutsing
- Research Division, Winners Foundation, Yaounde, Cameroon
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
| | - Ubraine Njineck Wunde
- Research Division, Winners Foundation, Yaounde, Cameroon
- Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
| | - Yvan Zolo
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Global Surgery Division, Faculty of Health Science, University of Cape Town, Cape Town, South Africa
| | - Geneviève Endalle
- Research Division, Winners Foundation, Yaounde, Cameroon
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
| | - Dieunedort Arnold Menga Djaowé
- Research Division, Winners Foundation, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
| | | | - Ines Miste Zourmba
- Research Division, Winners Foundation, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
| | - Aminatou Dadda
- Research Division, Winners Foundation, Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Garoua, Garoua, Cameroon
| | | | | | | | | | | | | | - Ignatius Esene
- Research Division, Winners Foundation, Yaounde, Cameroon
- Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon
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Lu Z, Tshimbombu TN, Abu-Bonsrah N, Kanmouyne US, Hesson D, Edward A, Dewan MC, Ukachukwu AEK, Fuller AT, Groves ML, Rhee DS. Transnational Capacity Building Efforts in Global Neurosurgery: A Review and Analysis of Their Impact and Determinants of Success. World Neurosurg 2023; 173:188-198.e3. [PMID: 36746238 DOI: 10.1016/j.wneu.2023.01.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Neurosurgical capacity building efforts attempt to address the shortage of neurosurgeons and lack of neurosurgical capacity in low- and middle-income countries. This review sought to characterize neurosurgical capacity building efforts in low- and middle-income countries and the challenges they face, and identify factors that predict higher engagement, better training, and performance of high-impact activities. METHODS A scoping review using PubMed and Embase databases was performed and relevant articles were identified. Programs were classified into 6 categories and the activities they performed were classified as having a high-, medium-, or mild impact on capacity. Programs were also classified using the Olivieri engagement and training criteria. RESULTS Fifty-seven articles representing 42 unique efforts were included. The most important determinant of impact was a program's design and intent. Furthermore, 91% of training and twinning programs received high (class 2 or 3) engagement classifications compared to 17% of mission trips and training camps (P < 0.001); 91% of training and twinning programs received high training classifications compared to 64% of mission trips and training camps (P = 0.015); and 91% of training and twinning programs reported performing high-impact activities compared to 29% of mission trips and training camps (P < 0.001). CONCLUSIONS Training and twinning programs are more engaged, offer better training, and are more likely to perform high-impact activities compared to mission trips and training camps, suggesting that these types of programs offer the greatest chance of producing substantial and sustainable improvements to neurosurgical capacity.
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Affiliation(s)
- Zhuoyan Lu
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA.
| | | | - Nancy Abu-Bonsrah
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Global Surgery Initiative, Baltimore, Maryland, USA
| | | | - Donna Hesson
- Welch Medical Library, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anbrasi Edward
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michael C Dewan
- Department of Neurological Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Duke University, Durham, North Carolina, USA; Department of Neurosurgery, Duke University Health System, Durham, North Carolina, USA; Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Mari L Groves
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniel S Rhee
- Division of Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Johns Hopkins Global Surgery Initiative, Baltimore, Maryland, USA
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Wireko AA, Ohenewaa Tenkorang P, Tope Adebusoye F, Mehta A, Cheng Ng J, Yaa Asieduwaa O, Fosuah Debrah A, Oti VN, Abdul-Rahman T, Sikora V. The state of African surgical research capacity: highlighting the current efforts, challenges, and recommendations - Editorial. Int J Surg 2023; 109:91-93. [PMID: 36799813 PMCID: PMC10389421 DOI: 10.1097/js9.0000000000000216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 02/18/2023]
Affiliation(s)
| | | | | | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Jyi Cheng Ng
- Faculty of Medicine and Health Sciences, University of Putra, Malaysia
| | - Owusu Yaa Asieduwaa
- Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi
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Abu-Bonsrah N, Totimeh T, Kanmounye US, Banson M, Bandoh D, Sarpong K, Dadey D, Adam A, Nketiah-Boakye F, Dakurah T, Boakye M, Haizel-Cobbina J, Ametefe M, Bankah P, Groves ML. Assessment of the Neurosurgical Capacity in Ghana: Challenges and Opportunities. World Neurosurg 2022; 167:e953-e961. [PMID: 36064120 DOI: 10.1016/j.wneu.2022.08.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND Low- and middle-income countries experience numerous challenges in the provision of neurosurgical care. However, limited information exists on the neurosurgical workforce and the constraints under which care is delivered in Ghana, West Africa. METHODS A 19-item survey assessing neurosurgical workforce, infrastructure, and education was administered to Ghanaian consultant neurosurgeons and neurosurgeon trainees between November 8, 2021, and January 20, 2022. The data were analyzed using summary descriptions, and qualitative data were categorized into themes. RESULTS There were 25 consultant neurosurgeons and 8 neurosurgical trainees (from 2 training centers) identified at 11 hospitals in Ghana totaling a workforce density of 1 neurosurgeon per 1,240,000. Most neurosurgical centers were located in Accra, the capital city. Almost half of the population did not have access to a hospital with a neurosurgeon in their region. Of hospitals, 82% had in-house computed tomography and/or magnetic resonance imaging scanners. In the operating room, most neurosurgeons had access to a high-speed drill (91%) but lacked microscopes and endoscopic sets (only 64% and 36% had these tools, respectively). There were no neurointensivists or neurological intensive care units in the entire country, and there was a paucity of neurovascular surgeries and functional neurosurgical procedures. CONCLUSIONS The provision of neurosurgical care in Ghana has come a long way since the 1960s. However, the neurosurgical community continues to face significant challenges. Alleviating these barriers to care will call for systems-level changes that allow for the prioritization of neurosurgical care within the Ghanaian health care system.
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Affiliation(s)
- Nancy Abu-Bonsrah
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon.
| | - Teddy Totimeh
- Department of Neurosurgery, University of Ghana Medical Centre, Accra, Ghana
| | | | - Mabel Banson
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Dickson Bandoh
- Department of Neurosurgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Kwadwo Sarpong
- Georgetown University School of Medicine, Washington, DC, USA
| | - David Dadey
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, California, USA
| | - Abass Adam
- Department of Neurosurgery, Tamale Teaching Hospital, Tamale, Ghana
| | | | - Thomas Dakurah
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Maxwell Boakye
- Department of Neurosurgery, University of Louisville, Louisville, Kentucky, USA
| | - Joseline Haizel-Cobbina
- Vanderbilt Institute for Global Health, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Mawuli Ametefe
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Patrick Bankah
- Department of Neurosurgery, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Mari L Groves
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Paradie E, Warman PI, Waguia-Kouam R, Seas A, Qiu L, Shlobin NA, Carpenter K, Hughes J, von Isenburg M, Haglund MM, Fuller AT, Ukachukwu AEK. The Scope, Growth, and Inequities of the Global Neurosurgery Literature: A Bibliometric Analysis. World Neurosurg 2022; 167:e670-e684. [PMID: 36028109 DOI: 10.1016/j.wneu.2022.08.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Here, we evaluate the evolution and growth of global neurosurgery publications over time, further focusing on the contributions and impact of authors in low- and middle-income countries (LMICs). METHODS In this systematic bibliometric analysis, we conducted a two-stage blinded screening process of global neurosurgery publications from 5 databases from inception through July 2021. Articles involving multi-national/multi-institutional research collaborations, detailing any area of global neurosurgery collaboration, or influencing global neurosurgery practice were included. Statistical hypothesis testing was conducted to analyze trends and hypotheses of LMIC authorship contributions. RESULTS The number of global neurosurgery publications has soared in the last decade. Overall, authors from HIC countries were most commonly from the US (41.1%), Canada (4.0%), and the UK (3.9%), while authors from LMIC countries were most commonly from Uganda (4.2%), Tanzania (2.6%), Cameroon (1.8%), and India (1.8%). Over a quarter (28%) of publications had no LMIC authors, while only 11% had 3 or more LMIC authors. The proportion of LMIC authors (LMIC-R) was not correlated with the citation rate of individual articles or with the year of publication, and a positive trend emerged when the LMIC-R of top-publishing LMICs was individually examined and compared to the year of publication. CONCLUSIONS Despite recent growth, the number of global neurosurgery publications arising from LMICs pales in comparison to those from HICs. Collaborative efforts between certain HICs and LMICs have likely contributed to the observed increase in LMIC author independence over time.
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Affiliation(s)
- Emma Paradie
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA
| | - Pranav I Warman
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA
| | - Romaric Waguia-Kouam
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Campbell University School of Osteopathic Medicine, Lillington, North Carolina, USA
| | - Andreas Seas
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Pratt School of Engineering, Duke University, Durham, North Carolina, USA
| | - Liming Qiu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurosurgery, Singapore General Hospital, Singhealth, Singapore, Singapore
| | - Nathan A Shlobin
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kennedy Carpenter
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA
| | - Jasmine Hughes
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Megan von Isenburg
- Duke University Medical Center Library and Archives, Durham, North Carolina, USA
| | - Michael M Haglund
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Anthony T Fuller
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University School of Medicine, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA; Duke Global Health Institute, Durham, North Carolina, USA
| | - Alvan-Emeka K Ukachukwu
- Duke Global Neurosurgery and Neurology, Durham, North Carolina, USA; Duke University Health System Department of Neurosurgery, Durham, North Carolina, USA.
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10
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Veerappan VR, Gabriel PJ, Shlobin NA, Marks K, Ooi SZY, Aukrust CG, Ham E, Abdi H, Negida A, Park KB, El Ouahabi A. Global Neurosurgery in the Context of Global Public Health Practice-A Literature Review of Case Studies. World Neurosurg 2022; 165:20-26. [PMID: 35697226 DOI: 10.1016/j.wneu.2022.06.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/05/2022] [Indexed: 12/30/2022]
Abstract
Neurosurgical conditions are a substantial contributor to surgical burden worldwide, with low- and middle-income countries carrying a disproportionately large part. Policy initiatives such as the National Surgical, Obstetrics and Anesthesia Plans and Comprehensive Policy Recommendations for the Management of Spina Bifida and Hydrocephalus in Low-and-Middle-Income countries have highlighted the need for an intersectoral approach, not just at the hospital level but on a large scale encompassing national public health strategies. This article aims to show through case studies how addressing this surgical burden is not limited to the clinical context but extends to public health strategies as well. For example, vitamin B12 and folic acid are micronutrients that, if not at adequate levels, can result in debilitating neurosurgical conditions. In Ethiopia, through coalesced efforts between neurosurgeons and policy makers, the government has made strides in implementing food fortification programs at a national level to address the neurosurgical burden. Traumatic brain injuries (TBIs) are another neurosurgical burden that unevenly affects LMICs. Countries such as Colombia and India have shown the importance of legislation and enforcement, coupled with robust data collection and auditing systems; strong academic advocacy of neurosurgeons can drastically reduce TBIs. Despite the importance of public health efforts in addressing neurosurgical conditions, there is a lack of neurosurgeon involvement in public health and lack of integration of neurosurgical burden in national health planning systems. It is imperative that neurosurgeons advocate for and are included in aspects of public health policy. Neurosurgery does not stop within the bounds of the hospital, and neither should the role of a neurosurgeon.
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Affiliation(s)
| | - Phabinly James Gabriel
- Rutgers University, New Jersey Medical School, Department of Surgery, Newark, New Jersey, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Katya Marks
- Medical Sciences Division, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | | | - Camilla G Aukrust
- Department of Neurosurgery, Oslo University Hospital, Oslo, Norway; Department of Community Medicine and Global Health, University of Oslo, Oslo, Norway
| | - Edward Ham
- Program in Global Surgery and Social Medicine, Harvard Medical School, Harvard, Cambridge, Massachusetts, USA
| | - Hodan Abdi
- Program in Global Surgery and Social Medicine, Harvard Medical School, Harvard, Cambridge, Massachusetts, USA; University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ahmed Negida
- College of Human Medicine, Zagazig University, Zagazig, Egypt; School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, United Kingdom
| | - Kee B Park
- Program in Global Surgery and Social Medicine, Harvard Medical School, Harvard, Cambridge, Massachusetts, USA
| | - Abdessamad El Ouahabi
- Neurosurgical Department, Hôpital des Specialités, Ibn Sina University Medical Center, Rabat, Morocco
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11
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Kanmounye US, Abu-Bonsrah N, Shlobin NA, Djoutsop OM. Letter: The World Health Organization's Intersectoral Global Action Plan on Epilepsy and Other Neurological Disorders 2022-2031. Neurosurgery 2022; 90:e201-e203. [PMID: 35383690 DOI: 10.1227/neu.0000000000001976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 02/23/2022] [Indexed: 11/19/2022] Open
Affiliation(s)
| | - Nancy Abu-Bonsrah
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Nathan A Shlobin
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Olga M Djoutsop
- Research Department, Association of Future African Neurosurgeons, Yaounde, Cameroon
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Dada OE, Ooi SZY, Bukenya GW, Kenfack YJ, Le C, Ohonba E, Adeyemo E, Narain K, Awad AK, Barrie U, Sichimba D, Ogunfolaji O, Kitonga LM, Oriaku AJ, Bamimore MA, Okor DE, Rominiyi O. Evaluating the Impact of Neurosurgical Rotation Experience in Africa on the Interest and Perception of Medical Students Towards a Career in Neurosurgery: A Continental, Multi-Centre, Cross-Sectional Study. Front Surg 2022; 9:766325. [PMID: 35223975 PMCID: PMC8866575 DOI: 10.3389/fsurg.2022.766325] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 01/18/2022] [Indexed: 11/18/2022] Open
Abstract
Objective Africa has the second highest neurosurgical workforce deficit globally and many medical students in Africa lack exposure to the field. This study aims to assess the impact of a neurosurgical rotation during medical school in shaping the perception and interest of students toward a career in neurosurgery. Study Design Cross-sectional study. Methods A Google form e-survey was disseminated to African clinical medical students between February 21st and March 20th, 2021. Data on exposure and length of neurosurgical rotation and perception of, and interest in, neurosurgery were collected. Data was analyzed using descriptive statistics and adjusted logistic regression modeling. Results Data was received from 539 students in 30 African countries (30/54, 55.6%). The majority of participants were male and were from Kenya, Nigeria and South Africa. Most students had undertaken a formal neurosurgery rotation, of which the majority reported a rotation length of 4 weeks or less. Students who had more than 4 weeks of neurosurgical exposure were more likely to express a career interest in neurosurgery than those without [odds ratio (OR) = 1.75, p < 0.04] and men were more likely to express interest in a neurosurgical career compared to women (OR = 3.22, p < 0.001), after adjusting for other factors. Conclusion Neurosurgical exposure is a key determinant in shaping the perception and interest of medical students toward a career in neurosurgery. Our findings support the need: i) for a continent-wide, standardized curriculum guide to neurosurgical rotations and ii) to advocate for gender inclusivity in education and policy-making efforts across the African continent.
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Affiliation(s)
- Olaoluwa Ezekiel Dada
- College of Medicine, University of Ibadan, Ibadan, Nigeria
- *Correspondence: Olaoluwa Ezekiel Dada
| | | | | | | | - Chi Le
- Vanderbilt School of Medicine, Nashville, TN, United States
| | - Efosa Ohonba
- Department of Neurosurgery, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Emmanuel Adeyemo
- University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Kapil Narain
- Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Ahmed K. Awad
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Umaru Barrie
- University of Texas Southwestern Medical Center, Dallas, TX, United States
| | - Dawin Sichimba
- Michael Chilufya Sata School of Medicine, Copperbelt University, Kitwe, Zambia
| | | | - Lilian Mwende Kitonga
- College of Health Sciences, School of Medicine, University of Nairobi, Nairobi, Kenya
| | | | - Michael A. Bamimore
- School of Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | | | - Ola Rominiyi
- Department of Neurosurgery, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
- Department of Neuroscience, University of Sheffield, Sheffield, United Kingdom
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